Arthur Becker-Weidman

Dyadic Developmental Psychotherapy: An evidence-baesd treatment

Early Neglect and Child Development

Early Neglect and Child Development:

Randomized trail compares children in institutions with those in foster care

Summarized by Arthur Becker-Weidman, PhD

 

Severe neglect and institutional care cause significant difficulties in attachment, biology, cognitive functioning including executive and neuropsychological functions, and behavioral and emotional regulation.  Studies of children in Romanian orphanages and other settings have demonstrated the pervasive and negative impact of such neglect on various domains of child development.  Those of us who work with such children know the complexities of helping families with these children.  Their difficulties may include disturbed patterns of attachment, sensory-integration dysfunction, various neuropsychological impairments, mental health issues, and problems with emotional and behavioral regulation.  These children are extremely challenging to work with and their families need comprehensive and supportive treatments. 

 

The Bucharest study, led by Charles Nelson, III, Nathan Fox, and Charles Zeanah, Jr., is a randomized trial comparing the emotional and physical well being of institutionalized children with those place in foster homes.  The study involved 136 children in orphanages in Romania.  The average age was 22 month, ranging from 6 to 31 months of age.  All children selected were free of neurological, genetic, and other birth defects based on a study-team pediatrician’s examination.  The children selected then has a series of baseline physical and psychological assessment.  Half the children were randomly assigned to foster care while the other half remained in the institution.  The children placed in foster care were placed in homes that had been recruited, trained, financed, and maintained by the study team.  This would be considered high quality foster care.  The study team also recruited a third group of typically developing children who lived with their birth families and who had never been institutionalized.  The study went on for ten years. 

 

One important finding that has significance not only for institutionalized children, but for all children who experience maltreatment is that there sensitive periods during which environmental influences are particularly powerful.  The study found that the average IQ of the institutionalized children, measured at thirty, forty, and fifty-two months was in the low to middle 70’s while it was ten points higher for the children in foster care.  In other words, after only between eight and thirty months longer in an insitutional setting, there was about a 12.5% drop in IQ.  The average IQ for the group of children never institutionalized was 100; or about 20% than the children in foster care.  Or, to put it differently, about  two years in an institution is associated with a 30% lower IQ.  The sensitive period seems to be the first two years.  The study found that a child placed in a home before two years of age had a significantly larger gain in IQ than a child placed in foster care after two years of age. 

 

The study measured attachment and found that the institutionalized children displayed incompletely formed and aberrant relationships with care-givers.  However children place in foster care, at 42 months of age (after an average of 20 months in foster care) displayed major improvements in making emotional attachments.  About half the children in foster care demonstrated secure attachments while only eighteen percent of the child in institutions demonstrated secure attachments.  Sixty-five percent of the children never placed in institutions displaced secure attachments.  This seems to demonstrate the capacity of healing relationships to help remedy these significant early deficits.  However, as with IQ, children placed in foster care before two years of age were more likely to form secure attachments when compared with children placed after two years of age. 

 

Foster care had a major influence on levels of anxiety and depression; reducing their incidence by half.  The more secure the attachment between the child and foster parent, the greater probability that the child’s symptoms would be reduced. 

 

The study examined brain activity using an EEG.  They found that infants in institutions has significant reductions in alpha and heightened theta waves, which they stated reflect delayed brain maturation.  When measured eight years later they found that children placed in foster care before two years of age showed no difference in EEG when compared with children never in an institution.  Children who remained in the institution and those placed in foster care after two years of age showed EEG patterns reflecting delayed brain maturation.  Institutionalized children had smaller brain volumes. 

 

Finally they examined telomeres, regions at the ends of chromosomes that provide protection from the stresses of cell division and which are shorter in people who have experienced extreme psychological distress than in those who have not experienced such stresses.  Children who spent any time in an institution had shorter telomeres than those who had not. 

 

REFERENCES

Almas, A., et. al., (2012).  Effects of Early Intervention and the Moderating Effects of Brain Activity on Institutionalized Children’s Social Skills at Age 8.  Proceeding of the National Academy of Sciences, 109 (2), 17,228-17,231.

 

Nelson, C., (2007).  Cognitive Recovery in Socially Deprived Young Children: The Bucharest Early Intervention Project.  Science 318, 1937-1940.

 

Scientific American (2013).  How Adversity Affects Young Children http://www.ScientificAmerican.com/apr2013/orphans, accessed May 11, 2013.

 

May 11, 2013 Posted by | Uncategorized | , , , , , , , , , , | Leave a comment

Attachment-Focused Treatment & Epigenetics

See more at http://www.attachment-focusedtreatmentinstitute.com/ 

Attachment-Focused Psychotherapy & Epigenetics:

What your grandparents past on.

 

Arthur Becker-Weidman, PhD

Center For Family Development

Attachment-Focused Treatment Institute

716 810 0790

http://www.attachment-focusedtreatmentinstitute.com/

AWeidman@Concentric.net

 

Is it possible for the experiences of your parents, grandparents, and great grandparents to have effects on you, your children, your grandchildren and beyond?  The answer is yes! But how is that possible?  Is it nature and genetics or is it psychology and nurture?  Is it bad genetics and biology or bad parenting?  Turns out it is both!

 

This article will summarize what we know about epigenetics and the implications of that for Attachment-Focused Treatment.  Your life experiences and those of your parents, grandparents, and great grandparents directly affect your genes and resulting behavior.

 

A bit of biology now.  Chromosomes are composed of genes which are composed of long strands of DNA.  DNA is wound around spools (histones) and how tightly the spools are wound determines how the gene is expressed.  If the DNA is wound tightly the gene will have little or no expression.  If the DNA is wound more loosely, then the gene and associated proteins will be expressed in large quantities.  When a  methyl group or acetyl group becomes attached to the DNA that changes the activity of the gene.  Attachment of a methyl group tightens to thread of DNA wrapping around the histone spool.  This makes it harder for the gene to produce the protein it codes.  When an acetyl group becomes attached to a gene the thread of DNA is more loosely wrapped around the histone spool resulting in greater gene expression.  Diet, chemicals, and various experiences including childhood maltreatment, drug abuse, and severe stress can cause methyl groups to become attached to genes.  These epigenetic changes can be passed down from parent to child and on to grand and great-grand children. 

 

Szyf & Meaney, two researchers at McGill in behavioral epigenetics, suggest that traumatic experiences in our past and ancestry leave molecular markers on our DNA.  Szyf & Meany found that maternal care causes changes in DNA methylation.  In a series of famous experiments using rats that were either highly attentive or highly in attentive, described in their 2004 article in Science, they found that in the hippocampus region (essential for the regulation of stress response), pups of inattentive mothers had highly methylated genes regulating the production of glucorticoid receptors, which regulate sensitivity to stress hormones.  Pups of the conscientious mothers had un methylated genes for  glucocorticoid receptors in the hippocampus.  More methylation results in less transcription.  So, the methylation of the genes in the pups of inattentive mothers reduced the number of glucocorticoid receptors from being transcribed in the pup’s hippocampus.  This means that those pups had an over-active stress response system and were generally more nervous and fearful. 

 

Whereas a nurturing environment can predispose a rodent to be calmer in adulthood and raise a nurturing family of its own, an adverse environment can have the opposite effect. There’s evidence that this effect, too, may involve epigenetic changes. Last year, researchers led by Tania Roth and J. David Sweatt of the University of Alabama, Birmingham, helped show this by building on earlier work showing that rat mothers denied access to the materials needed to make a proper nest become anxious and spend less time nurturing their young. Pups raised by these stressed-out rat moms exhibited increased methylation of the gene for BDNF, a neural growth factor, in the brain’s prefrontal cortex, they reported in the 1 May 2009 issue of Biological Psychiatry. In addition, this methylation pattern, which would tend to reduce the amount of BDNF produced, was passed on to the subsequent generation. (Miller, 2010)

This suggests that Jews whose great-grandparents were in concentration camps, Chinese whose grandparents lived through the ravages of the Cultural Revolution, young immigrants from Africa whose parents survived brutal civil wars and genocidal massacres, and adults who grew up with alcoholic or abusive parents, all carry with them more than just memories…our experiences and those of our forebears are never gone, even if they have been forgotten.  They become a part of us, a molecular residue on our genetic scaffolding.  The DNA remains the same, but the psychological and behavioral tendencies are inherited.  You might have inherited not just your grandparent’s eye color and freckles, but also their predisposition toward depression caused by the neglect they suffered as infants and young children.  On the other hand, if your parent or grandparent, who was born to a maltreating family, was adopted at an early age by a nurturing, supportive, and loving family, then they and you will be privy to an epigenetic boost; strengths and resiliencies are also passed on. 

 

Sackler Program for Epigenetics and Psychobiology at McGill University found that childhood abuse amongst suicide victims was associated with a distinct epigenetic mark on the DNA. The discovery represents a huge step forward for epigenetics—the study of how environmental factors change gene expression—and holds the promise of better understanding suicide and, perhaps, new treatments. team used a cohort of 36 brain samples. One third were from suicide subjects who were known to have been abused in childhood, one third from suicides with no known abuse in their childhoods, and one third from a control group. The researchers discovered that those suicides who had suffered abuse as children bore specific epigenetic methylation characteristics absent on specific DNA sites that were in the other two groups. Significantly, those marks were shown to influence the hypothalamic-pituitary-adrenal (HPA) function. The HPA axis is a critical feature of the stress response. It is managed by a set of genes expressed in the hippocampus, including one that was epigenetically marked by the experience of childhood abuse. Abnormal HPA activity in response to stress is in turn strongly linked to suicidal action.   They found excess emthylation of the genes in the suicide brains’ hippocampus, a region critical for memory acquisition and for the regulation of the stress response. 

 

In a landmark study, Szyf looked at the blood samples of forty men all born in 1958, who were either very poor or very rich at some point in their lives.  Genes were more than twice as likely to show methylation changes based on family income during early childhood.  Timing matters!  Early experiences have more impact on the developing brain and on genetic expression than later experiences.   Yu and colleagues (Yu, et. al., 2012) compared blood samples of 14 children raised in Russian orphanages with 14 other Russian children being raised by their birth parents.  The research team found markedly greater methylation in the institutionalized children’s genes, particularly those influential in neural communication, brain development, and brain functioning. ” The findings suggest that patterns of differential methylation seen in nonhuman species with altered maternal care are also characteristic of children who experience early maternal separation,” (p. 143).  Elena Grigorenko at Yale, one of the study’s authors stated, “Our study shows that the early stress of separation from a biological parent impacts long-term programming of genome function.  This might explain why adopted children may be particularly vulnerable to harsh parenting in terms of their physical and menthal health.  Parenting adopted children might require much more nurturing care to reverse these changes in genome regulation.”   

 

One clear implication of this research is that the Attachment-Facilitating Parenting associated with Attachment-Focused Psychotherapy can be instrumental in de-methylating important genes and, therefore, “resetting” the stress response system to be within a more normal range.  It is clear that harsh parenting methods, methods grounded in power and control, methods that are shaming, blaming, and critical only serve to reinforce negative expectations and the unresponsive stress-response system’s reset mechanism.  Parenting methods that are grounded in a focus on relationship and connections of an emotionally meaningful and joyful nature may reset the stress response system by its epigenetic effects.

April 15, 2013 Posted by | Uncategorized | , , , , , , , , | 1 Comment

The Dyadic Developmental Psychotherapy Primer

The Dyadic Developmental Psychotherapy Primer is now out in print and Kindle at Amazon.  This book describes the principles of Attachment-Focused Treatment, the components of treatment, and the differential use of those 14 components in the five phases of treatment.  It is essential a treatment manual, with many clinical examples, describing the essential elements of attachment-focused family therapy.  

April 10, 2012 Posted by | Uncategorized | , , , , , , , | 4 Comments

Webinar: Complex Trauma

Assessing Complex Trauma

This workshop will describe a three session model for the assessment of Complex Trauma (aka Developmental Trauma Disorder). A brief description of what is Complex Trauma and its effects on child development and the importance of parenting will be followed by a presentation of the assessment protocol. This assessment protocol is multi-modal and uses data from records, caregivers, various psychometric instruments. Screening of the various domains of possible impairment is an essential element of this protocol.

This workshop will only be available through Webinar (instructions on how to access the Webinar will be provided upon registration)

Date: June 15th, 2012 10:00am – 11:30am

Workshop Leaders:

Arthur Becker-Weidman, Ph.D., Center for Family Development

Emily Becker-Weidman, PhD, Child Study Center, New York University

To register, please complete the attached registration form and send to Maribel Cruz

(p) 212-660-1318

(f) 212-660-1319

Email: MaribelC@nyfoundling.org

Vincent J. Fontana Center for Child Protection

27 Christopher Street, New York, NY 10014
The New York State
Chapter of American
Professional Society on the Abuse of Children
Presents
The 2011/2012
Child Abuse
Workshop Series
Co-Sponsored by
The New York Foundling
Vincent J. Fontana Center for Child Protection
Villano Conference Center
27 Christopher Street
New York, New York 10014
http://www.nyfoundling.org/fontana-center
Workshops
1. Preventing Foster Home Disruption: A Programmatic Approach
This workshop is for mental health clinicians, case planners, supervisors and administrators working in the child welfare system. The workshop will identify the risk factors that contribute to foster home disruption and describe clinical and social service interventions designed to
stabilize the foster home and prevent disruption of the foster home.
Date/Time: October 24, 2011 10:00am to 11:30am
Workshop Leader: Mel Schneiderman, Ph.D
Director of Mental Health Services
New York Foundling
Co-founder Vincent J. Fontana Center for Child Protection
2. Forensically Defensible Child Sexual Abuse Evaluations
This workshop, presented by a defense attorney, will focus on issues which arise in the context of child sexual abuse litigation including Parental Alienation “Syndrome,” the suggestibility of children, allegations of child sexual abuse in the context of divorce/custody proceedings, proper forensic interviewing, the professional ethics of mental health professionals maintaining proper records, and other issues.
Date/Time: December 5, 2011 10:00am to 12pm
Workshop Leader: Lawrence Jay Braunstein Esq.
Partner in the Firm of Braunstein & Zuckerman, Esq.
3. Common Myths and Clinical Realities of Child Maltreatment
Child abuse is the physical, sexual, emotional mistreatment or neglect of children. This
workshop will provide a multi-disciplinary forum to explore commonly held beliefs that can
often derail the process of obtaining the best outcomes for a child who has experienced any of these forms of child abuse. Through case-based discussion interspersed with brief didactics we will explore common myths as they relate to each of the forms of child maltreatment while
integrating findings from the literature in the field.
Date/Time: February 3, 2012 10am to 12pm
Workshop Leader: Ingrid Walker-Descartes, MD, MPH, FAAP
Maimonides Infants and Children’s Hospital of Brooklyn Child Abuse Pediatrician
Attending – Pediatric Ambulatory Division
Program Director – Pediatric Residency Training Program
4. Evidence-Based Mental Health Interventions for Child Abuse
This workshop will describe the current state of evidence-based mental health interventions for childhood abuse. Childhood models of PTSD and other sequelae will be described briefly. Em-pirically supported treatment for child sexual abuse, physical abuse and emotional/psychological abuse will be reviewed. Critical issues in treating youth will be described and finally national and state dissemination efforts will be noted, with focus on how New York State can adopt best prac-tices for the treatment of abused children.
Date/Time: April 2, 2012 10am to 11:30am
Workshop Leader: Komal Sharma-Patel, PhD
Assistant Director of Research
PARTNERS Program
St. John’s University
5. Integrating Prevention into Your Practice: American Professional Society on the Abuse of Children Prevention Guidelines
While much of professional practice has the objective of preventing further maltreatment, it is often difficult to understand how to best incorporate prevention activities into our work. This workshop will be hosted by a member of the American Professional Society on the Abuse of Children Board Prevention Task Force who will review current evidence and best practices in the child maltreatment field and discuss guidelines to assist professionals in integrating preven-tion into their work.
Date/Time: May 1, 2012 10am to 11:30am
Workshop Leader: Vincent J. Palusci, MD MS
Professor of Pediatrics at NYU School of Medicine
Child Abuse Pediatrician at the Frances L. Loeb Child
Protection and Developmental Center at Bellevue Hospital
6. Assessing Complex Trauma
This workshop will describe a three session model for the assessment of Complex Trauma (aka Developmental Trauma Disorder). A brief description of what is Complex Trauma and its effects on child development and the importance of parenting will be followed by a presentation of the assessment protocol. This assessment protocol is multi-modal and uses data from records, care-givers, various psychometric instruments. Screening of the various domains of possible impair-ment is an essential element of this protocol.
This workshop will only be available through Webinar
Date and Time to be announced
Workshop Leaders: Arthur Becker-Weidman, Ph.D.
Center for Family Development
Emily Becker-Weidman, PhD
Child Study Center, New York University
The New York State Chapter of
American Professional Society on the
Abuse of Children
The New York State Chapter of the American Professional Society on the Abuse of Children provides an opportunity for professionals in New York State to meet, share ideas and experiences, develop strategies for improving
professional services to clients, influence public policy and educate the public, other professionals, and policy makers about child maltreatment.
The New York Foundling
Vincent J. Fontana Center
for Child Protection
The Fontana Center supports the mission and values of The New York Foundling by serving as the advocacy,
public policy, research, professional and community
education arm of the agency.
The Center’s mission is to eliminate child maltreatment through the identification and promotion of evidence based primary prevention and treatment strategies. To achieve this objective, The Fontana Center engages in
research, professional training, community education and advocacy.
Registration Form
Please, indicate which workshop you would like to register for below.
1._____Preventing Foster Home Disruption: A Programmatic Approach
(October 24, 2011 10:00am to 11:30am)
2. Forensically Defensible Child Sexual Abuse Evaluations
(December 5, 2011 10:00am to 12pm)
3._____Common Myths and Clinical Realities of Child Maltreatment
(February 3, 2012 10am to 12pm)
4._____Evidence-Based Mental Health Interventions for Child Abuse
(April 2, 2012 10am to 11:30am)
5. Integrating Prevention into Your Practice: APSAC Prevention Guidelines (May 1, 2012 10am to 11:30am)
6._____Assessing Complex Trauma: Webinar Only
(Date: TBA)
There is no fee for New York State APSAC members or for NY Foundling staff.
There is a $10.00 fee for all non NYS APSAC members.
Please make check payable to:
Vincent J. Fontana Center for Child Protection
All workshops will be held at the Vincent J. Fontana Center for Child Protection
at 27 Christopher Street in Manhattan.
Subway stops: West 4th (A,C, E, F, B, D, M trains) or Christopher Street (1 train)
Send check and registration form to Maribel Cruz at:
maribelc@nyfoundling.org
Vincent J. Fontana Center for Child Protection
27 Christopher Street, New York, NY 10014
Phone: 212-660-1318

February 13, 2012 Posted by | Adoption, Arthur Becker-Weidman, Brain, Child Abuse, Child development, Child Welfare, Dr. Arthur Becker-Weidman, Dr. Becker-Weidman, Dyadic Developmental Psychotherapy, Empirically supported, Evidence-based, International Adoption, Parenting, Psychology, Research, Special Education, Treatment, Vineland Adaptive Behavior Scales | , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Working with Culturally diverse groups

I’ve been reading and thinking, recently, about work with culturally diverse groups and wonder if any of you do and what your experience has been.

In thinking about treatment it seems that family and DDP therapists (who are primarily European-American) may tend to:
* Allow and encourage expressing emotions freely and openly
* View each member as having a right to the member’s own unique self: to individuate from the family as a primary unit of identity
* Strive for equal division of labor among members of the family
* Consider egalitarian role relationships between spouses as preferred
* Focus on the nuclear family as the standard.
* Value a present-future time perspective

A variety of other cultures have differing values and orientations (Asian, South-Asian, Black American, First Nations/Native American, Hispanic, to name a few).

It might be interesting to have a discussion about working with culturally diverse groups…if any of us do work with such groups (I do, so that’s what prompted my readings and thinking).

February 12, 2012 Posted by | Adoption, Arthur Becker-Weidman, Child development, Child Welfare, Dr. Arthur Becker-Weidman, Dr. Becker-Weidman, Dyadic Developmental Psychotherapy, Empirically supported, International Adoption, Legal Issues, Parenting, Psychology, Research, Special Education, Treatment | , , , , , , , , , , , , , , , , , | Leave a comment

Spanking’s negative outcomes

A comprehensive study of the literature in the Canadian Medical Journal finds that spanking children results in poor outcomes: lower IQ scores.

The arguments against spanking and corporal punishment are even stronger when considering its re-traumatizing effects on children who have experienced complex trauma.

February 10, 2012 Posted by | Adoption, Arthur Becker-Weidman, Brain, Child Abuse, Child development, Child Welfare, Dr. Arthur Becker-Weidman, Dr. Becker-Weidman, Dyadic Developmental Psychotherapy, Empirically supported, Legal Issues, Parenting, Psychology, Research, Treatment | , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Attachment Therapy Companion

The book I wrote with 2 colleagues, Attachment Therapy Companion, will be out in July an is now listed on the Norton website:

http://books.wwnorton.com/books/Attachment-focused-Therapy/

The book is meant to be a statement of best practice in the provision of attachment focused therapy. It described the theory base for this approach, appropriate and evidence-based principles for evaluation and treatment, and ethical principles of practice.

It is a must read for anyone practicing treatment grounded in attachment theory.

February 5, 2012 Posted by | Adoption, Arthur Becker-Weidman, Child Abuse, Child development, Child Welfare, Dr. Arthur Becker-Weidman, Dr. Becker-Weidman, Dyadic Developmental Psychotherapy, Education, Empirically supported, Evidence-based, Legal Issues, Parenting, Psychology, Research, Special Education, Treatment | , , , , , , , , , , , , , , , , , , , , , , , | 1 Comment

Presentation on Complex Trauma for Value Behavioral Health

I’m in Pittsburgh now, November 17, 2011. I’ll be doing a presentation for Value Behavioral Health about evaluating and treatment Complex Trauma tomorrow. VBH manages the Medicaid contract for the State of PA for Western PA, so there will be about 350 providers at the training.

November 17, 2011 Posted by | Adoption, Arthur Becker-Weidman, Child Abuse, Child development, Child Welfare, Dr. Arthur Becker-Weidman, Dr. Becker-Weidman, Dyadic Developmental Psychotherapy, IEP, Legal Issues, Parenting, Psychology, Special Education, Treatment | , , , , , , , , , , , , , , , , , | Leave a comment

Attachment Therapy Book

I’ve just heard that a book I wrote with two colleagues,
The Attachment Therapy Companion: Key Practices for Treating Children
& Families

is now in production and should be out in early 2012. The book
describes what are the standards of care for this treatment.
From the Introduction:

This book is an important contribution to the field of trauma
treatment and attachment-focused the therapy. It provides the
clinician with a framework to assess, develop treatment plans, and
provide treatment in a comprehensive and integrated manner. College
professors are afforded a guide for classroom instruction. The book
will provide consumers with the necessary tools and information to
make better informed decisions regarding the adequacy of care they are
getting. College professors will find this book a useful adjunct for
family therapy, treatment, and ethics classes and the study guide will
assist in classroom instruction. Finally the book will provide judges,
child welfare professionals, insurance companies, and others with a
framework for evaluating proposed plans of care. It is my belief that
this book will mark a new stage in the development of attachment-
focused therapy by delineating what are the standards of care for the
treatment of attachment and trauma disorders.

November 12, 2011 Posted by | Adoption, Arthur Becker-Weidman, Brain, Child Abuse, Child development, Child Welfare, Dr. Arthur Becker-Weidman, Dr. Becker-Weidman, Dyadic Developmental Psychotherapy, Empirically supported, Evidence-based, International Adoption, Legal Issues, Parenting, Psychology, Research, Special Education, Treatment | , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

for parents on Halloween

For parents, this link has some helpful information.

http://www.huffingtonpost.com/mary-l-pulido-phd/protecting-kids-first-a-s_b_991354.html

October 23, 2011 Posted by | Adoption, Arthur Becker-Weidman, Child Abuse, Child Welfare, Dr. Arthur Becker-Weidman, Dr. Becker-Weidman, Dyadic Developmental Psychotherapy, Parenting | , , , , , , , , , , , , | Leave a comment